Locally advanced prostate cancer

What is locally advanced prostate cancer?

Locally advanced prostate cancer is cancer that has started to break out of the prostate, or has spread to the area just outside the prostate.

Watch our animation to find out more about the different stages of prostate cancer:

You may hear locally advanced prostate cancer called stage T3 or T4 prostate cancer. It may have spread to your:

prostate capsule, which is the outer layer of the prostate
seminal vesicles, which are two glands that sit behind your prostate and store some of the fluid in semen (the fluid that carries sperm)
pelvic lymph nodes, which are part of your immune system and are found near your prostate
bladder, which is the part of the body where urine (pee) is stored
back passage (rectum).

Different doctors may use the term ‘locally advanced prostate cancer’ to mean slightly different things, so ask your doctor or nurse to explain exactly what they mean. They can explain your test results and the treatment options available. Or you could call our Specialist Nurses for more information and support.

What do my test results mean?

Your test results will help your doctor understand how far your cancer has spread and how quickly it might grow. This will help you and your doctor to discuss what treatments might be suitable for you.

What are my treatment options?

Locally advanced prostate cancer is cancer that has started to break out of the prostate, or has spread to the area just outside the prostate.

The treatment options for locally advanced prostate cancer are:

external beam radiotherapy with hormone therapy (and sometimes with high dose-rate brachytherapy)
surgery (radical prostatectomy), often followed by hormone therapy and radiotherapy
hormone therapy alone
watchful waiting.

A small number of men may be offered high dose-rate brachytherapy on its own, but this isn’t very common.

Depending on how far your cancer has spread, you may have a choice of treatments. If so, your doctor or nurse will talk you through your treatment options and help you choose the right treatment for you. You might not be able to have all of the treatments listed above. Read more about choosing a treatment.

What is my outlook?

Many men will want to know how successful their treatment is likely to be. This is sometimes called your outlook or prognosis. No one can tell you exactly what your outlook will be, as it will depend on many things, such as the stage of your cancer and how quickly it might grow, your age, and any other health problems.

Many men with locally advanced prostate cancer have treatment that aims to get rid of their cancer. For some men, treatment may be less successful and the cancer may come back. If this happens, you might need further treatment.

Some men with locally advanced prostate cancer will have treatment that aims to help keep their cancer under control rather than get rid of it completely. For example, if you have hormone therapy on its own, it can help to keep the cancer under control. And there are other treatments available if your hormone therapy stops working so well.

For more information about the outlook for men with prostate cancer, visit the Cancer Research UK website. The figures they provide are a general guide and they cannot tell you exactly what will happen to you. Speak to your doctor or nurse about your own situation.

References

Updated: September 2016｜To be reviewed: September 2018

List of references
- British Uro-oncology Group (BUG), British Association of Urological Surgeons (BAUS). Multi-disciplinary Team (MDT) Guidance for Managing Prostate Cancer. 2013.
- National Institute for Clinical Excellence. Prostate Cancer: diagnosis and treatment. Full guideline 175. 2014.
- Yoshioka Y, Suzuki O, Otani Y, Yoshida K, Nose T, Ogawa K. High-dose-rate brachytherapy as monotherapy for prostate cancer: technique, rationale and perspective. J Contemp Brachytherapy. 2014;1:91–8.
- Yoshioka Y, Suzuki O, Isohashi F, Seo Y, Okubo H, Yamaguchi H, et al. High-Dose-Rate Brachytherapy as Monotherapy for Intermediate- and High-Risk Prostate Cancer: Clinical Results for a Median 8-Year Follow-Up. Int J Radiat Oncol. 2016 Mar;94(4):675–82.